The Senate confirmed Sylvia Mathews Burwell on Thursday as the new secretary of the Department of Health and Human Services by a bipartisan vote of 78-17.

Burwell, the outgoing director of the White House Office of Management and Budget, was President Barack Obama’s top choice to succeed the embattled Kathleen Sebelius, who announced plans to step down as secretary in April.

Sebelius, who’d served since the beginning of the administration, oversaw the shaky rollout of the Affordable Care Act, which has been a constant source of congressional bickering and a persistent drag on the president’s approval ratings.

Burwell takes over as the agency tries to implement the health care law amid strong political opposition and the ongoing ripple effects of the botched debut last fall of the federal insurance marketplace, HealthCare.gov.

An overwhelming favorite for confirmation since she was tabbed for the position, Burwell, a native of Hinton, W.Va., had strong support from both sides of the aisle: 52 Democrats, two independents and 24 Republicans. Among the Republicans who opposed her were Marco Rubio of Florida, Roy Blunt of Missouri, Ted Cruz and John Cornyn of Texas, Mitch McConnell and Rand Paul of Kentucky, and Jerry Moran and Pat Roberts of Kansas.

Obama applauded the bipartisan majority that confirmed her.

“Sylvia is a proven manager who knows how to deliver results, and over her career she has built deep relationships with Democrats and Republicans alike,” the president said in a statement. “I’m confident Sylvia’s unparalleled experience will serve her well in her new role as she works to ensure the safety of our food and drug supply, protect our nation from outbreaks or bio-terror attacks, keep America at the forefront of medical research and make sure every American has access to quality, affordable health care.”

Calling her a “shining star and a devoted public servant,” Senator Jay Rockefeller, a Democrat from her home state of West Virginia, said Burwell’s confirmation “speaks directly to her abilities and record of accomplishment.”

McConnell, the Senate minority leader, was a notable exception, voting against Burwell because “her embrace of Obamacare calls her policy judgment into question.”

“I'll be voting against this nominee, because I think we need to focus on repealing and replacing this law, not trying to do the impossible by pretending we can make it work,” McConnell said during a floor speech.

Sen. Orrin Hatch of Utah, however, summarized the feelings of most fellow Senate Republicans, saying Burwell had a difficult job ahead of her.

“While I support her nomination, no one should mistake that to mean that I have somehow softened in my resolve against Obamacare,” he said on the Senate floor. “Indeed, I am as committed as ever to repealing and replacing this horribly misguided law.”

After being unanimously confirmed to head the OMB last year, Burwell helped manage the federal government shutdown in October and tried last summer to negotiate a “grand bargain” between Senate Republicans and the White House to cut government spending and raise taxes.

She has extensive managerial expertise in both the public and private sectors. She served as the president of the Walmart Foundation and was the president and chief operating officer of the Global Development Program at the Bill & Melinda Gates Foundation. She also served on the board of the Council on Foreign Relations, a research center.

During eight years in the Clinton administration, Burwell held a variety of positions, including staff director of the National Economic Council, chief of staff to the secretary of the treasury and deputy director of the OMB.

Burwell has undergraduate degrees from Harvard University and Oxford University, where she was a Rhodes Scholar.

Email: tpugh@mcclatchydc.com; Twitter: @TonyPughDC. Lesley Clark and David Lightman contributed to this article.